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Treatment
Date of visit
Total [Payments]: 18,850
3221 Date of visit03/09/2025 C/C & Rx plans Treatments13- DO composite filling Prescription Payment1,400.00 Balance Follow up date Lab
1748 Date of visit19/10/2023 C/C & Rx plans Treatments22 and 23 class 4 composite filling Prescription Payment2,600.00 Balance Follow up date Lab
1575 Date of visit03/08/2023 C/C & Rx plans Treatments15 ext Prescription Payment450.00 Balance Follow up date Lab
1411 Date of visit21/06/2023 C/C & Rx plans Treatments14 obturation Prescription Payment1,500.00 Balance Follow up date Lab
1367 Date of visit26/05/2023 C/C & Rx plans Treatments14 pre endo access and bmp Prescription Payment2,500.00 Balance Follow up date Lab
1198 Date of visit22/03/2023 C/C & Rx plans Treatments26 27 Crown fixation done Prescription Payment3,000.00 Balance Follow up date Lab
1176 Date of visit09/03/2023 C/C & Rx plans TreatmentsCrown prep on 26 Old Crown prep refined on 27 Prescription Payment3,000.00 Balance3,000.00 Follow up date LabLewis
903 Date of visit25/11/2022 C/C & Rx plans Treatments12 DO class 4 composite filling Under Rd Neospextra sd Prescription Payment1,200.00 Balance Follow up date Lab
898 Date of visit22/11/2022 C/C & Rx plans Treatments25 MO class 2 composite filling Under RD Contact ok not tight Prescription Payment1,200.00 Balance Follow up date Lab
408 Date of visit28/04/2022 C/C & Rx plans Treatments47 class 1 composite 43 class 2 composite filling do Prescription Payment2,000.00 Balance Follow up date Lab
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